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GI Motility

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GI motiliy
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  • Added: April, 08th 2011
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Content Preview
Actions
Stimuli & receptors
Affernent pathway
Integration centers
Efferent pathway
Effectors & effects
Functions
Food in mouth > bolus
Facilitate swallowing,
Motor branch of CNV
Jaw chewing muscles
compressed against lining
prevent injury of
(inhibited)
RELAX > Jaw drops
of mouth
pharyngeal and
Mastication
Jaw drop > stretch
Rebound contraction of
esophageal linging,
Reflex
Motor branch of CNV
receptors of jaw muscles
jaw muscles
mixing with saliva,
increase surface area for
Taste
Taste center in brainstem
Motor branch of CNV
Rhythmic chewing
digestion
Swallowing center in
Tongue pushes bolus up
Transport food to
Deglutition: Oral phase
(voluntary)
medulla
and back
pharynx
Close posterior nares
Soft palate pulled upward (choanae) > prevent food
reflux into nasal cavities
(1)Pull up and enlarge
esophageal opening;
(2)Epiglottis covers glottis
> Prevent food from
Swallowing center in
CNV, IX, X, XII, few
neck muscles > larynx
entering trachea; (3)Relax
medulla (near tractus
Food in pharynx >
Sensory portion of
superior cervical nerves
raised
upper esophageal
Deglutition: Pharyngeal
solitarius)
pressure receptors in
trigeminal and
sphincter, then it
phase
posterior wall of pharynx
glosspharyngeal nerves
contracts after the food
passes > prevent air entry
into esophagus
Force food into upper
esophagus > primary
Fast peristaltic wave
peristaltic wave in
esophageal phase
Swallowing center
C3-5
Breathing muscles
Inhibit respiration
inhibits respiratory center
Primary peristaltic wave: continuation of peristaltic wave during pharyngeal phase
Food left in esophagus >
Intrinsic neural circuit in
Intraluminal pressure +
the myenteric nervous
distension of esophagus
system
Secondary peristaltic
Glossopharyngeal and
Esophageal striated
wave
vagus nerves
muscles
Pharyngeal peristalsis
Vagal affernet fibres
Medulla
Vagus nerve (mainly) >
Esophageal smooth
myenteric plexus
muscles
Deglutition: Esophageal
Prepare the stomach for
phase
Wave of relaxtion from
Vagus nerve (mainly) >
Receptive relaxation of
receiving food with
descending esophageal
Vagal affernet fibres
Vagovagal reflex
myenteric inhibitory
proximal stomach muscle
negligible increase in
peristaltic wave
nuerons
coat
pressure
Allow food entering the
Intraluminal pressure +
Vagus nerve (mainly) >
Receptive relaxation of
stomach > after the food
peristaltic swallowing
Vagal affernet fibres
Vagovagal reflex
myenteric inhibitory
lower esophageal
passes, returns to tonic
wave in esophagus
nuerons
sphincter
constriction of lower
esophageal sphincter
Food in stomach >
Vagus nerve (mainly) >
Reduce muscle tone of
Stomach: storage
distension > stretch
Vagal affernet fibres
Vagovagal reflex
myenteric inhibitory
the muscular wall of
Accommodate more food
receptors
nuerons
stomach
(1)Mixing food with
Weak peristaltic
gastric juice (mainly in
constrictor (Mixing)
antrum); (2)Constrictor
(Spontaneous) regularly
myenteric excitatory
Basic electrical rhythm
waves in from upper to
rings puching food
occurring depolarisation
nuerons
mid protion of stomach
toward the pylorus >
Stomach: mixing and
wall to antrum
closure of pylorus +
propulsion
retropulsion
Intense contrictor rings >
Propel chyme back into
myenteric excitatory
Presence of food in
Retropulsion/rapid
the antrum > further
nuerons > peristaltic
stomach
contraction of terminal
mixing and breaking
action potential
antrum
down of food particles
Antrum quiescent for 75
Sweeps the stomach
Cyclic contractile activity:
to 95 min, then brief (5-
Stomach: motility in
(small intestine), clear of
migrating myoelectric
10min) strong
fasted state
any debris left from
complex
contractions with a
previous meal
relaxed pylorus
Srong peristaltic wave
myenteric excitatory
Provide propulsion force
from body of stomach to
Increased food volume in
Stretch receptor >
nuerons
for stomach emptying
Local myenteric reflex
pylorus > pyloric pump
stomach > distension
myenteric plexus
myenteric inhibitory
Inhibit pylorus
Allow emptying
nuerons
Stomach: Emptying
Distension of stomach
Stretch receptor
wall
Strong peristaltic wave
G-cells in antrum >
Provide propulsion force
Gastric acidity
Chemoreceptor
Submucosal plexus
from body of stomach to
Gastrin > endocrine
for stomach emptying
Digestion products of
pylorus > pyloric pump
Chemoreceptor
proteins

Distension of duodenum
(1)Enteric nervous system
Irritation of duodenal
from duodenum to
(1)Inhibit pyloric pump
mucosa (if any)
stomach;
propulsive contraction;
Acidity of duodenal
(2)Prevertebral ganglia >
Prevent over-emptying of
(2)Increase the tone of
chyme (pH <3.5)
inhibitory sympathetic
acidic chyme which the
pyloric sphincter
Hypertonic solution in
Inhibtion of stomach
fibers to atomach;
duodenum cannot handle
duodenal chyme
emptying when food
(3)Vagovagal reflex
(intestinal neutralization
Digestion products of
enters duodenum
and digestion) > better
proteins and fats
digestion of food &
I cell in jejunal mucosa >
Block increased stomach
protect small intestine
CCK > blood
motility due to gastrin
Fats in small intestines
Binding to receptors on
Upper small intestine >
Blood > receptors on
Reduce GI motility to a
the epithelium
GIP
stomach muscular wall
lesser extent
Acidity of duodenal
S cell in duodenal mucosa
Reuce GI motility
chyme
> secretin > blood
Small intestine: mixing
Localized concentric
contractions
Distension of small
Myenteric plexus of small
contractions spaced at
Stretch receptors
Enteric nervous system
Mixing
(segmentation
intestine
intestinal wall
close intervals, lasting for
contractions)
a fraction of a minute
Progressive contractions
Stretch of duodenal wall
Myenteric plexus of small
of successive
Propel food forward
intestinal wall
sections of circular
slowing + long transit
Stretch of stomach wall
Gastroenteric reflex
smooth muscle
time allows efficient
Small intestine:
enhance intestinal
digestion and absorption
Chemistry of chyme
Chemoreceptor
Enteroendocrine cells
Gastrin, CCK, motilin
propulsion (peristaltic
motility
contraction)
Food in stomach
S cell > Scretin
Inhibit intestinal motiltiy
Prevent further
Distension of cecum
Myenteric plexus of ileum
Inhibit ileal motiltiy
congestion of large bowel
Myeneteric plexus or
Allow ileal materials
Distension of ileum
Relax ileocecal valve
extrinsic autonomic
Myenteric plexus of the
entering colon
Ileocecal valve
nerves esp prevertebral
valvular muscle
Distension of colon
Contract ileocecal vlave
Prevent reflux
sympathetic ganglia
Protect teeth enamel
Distension of duodenum
CN VII, CN IX
(1) Increased salivation
from gastric acids
Vagus nerve, enteric
(2) Reverse peristalsis
nervous system
Propel food back to
Irritation of duodenum
from mid intestine to
duodenum
CN V, VII, IX, X, XII
duodenum
Irritation of esophagus
Vagal afferents,
Receive content from
(3) Relax pyloric sphincter
and stomach
sympathetic afferents
duodenum
Vomitting
Somatic spinal nerves
(4) Force inspiration
Prepare for expiration
Vomitting (Emesis)
Pharyngeal irritation
center in
CN X (vagus)
(gag reflex)
(5) Raising hyoid bone &
Open upper esophageal
Somatic spinal nerves
medulla
larynx
sphincter, close glottis
(Neurotransmitters:
histamine, acetylcholine,
Somatic spinal nerves
(6) Lifting soft palate
Close posterior nares
dopamine, noradrenaline,
Stress, psychiatric
Limbic system
adrenaline, 5-
disorders
hydroxytryptamine,
(7) Diaphragm contracts
C4
Increase intra-abdominal
substance P)
forcefully
pressure > compress
chemoreceptor trigger
(8) Abdominal muscles
Drugs
T7-12
stomach
zone (CTZ)
contract forcefully
Unsteady motion >
CN VIII
(9) Relax lower
Outflow from stomach to
vestibular labyrinth in
(vestibulocochlear) >
CN V, VII, IX, X, XII
esophageal sphincter
esophagus
inner ear
cerebellum > CTZ
Distension of stomach
Large intestine:mass
Autonomic nervous
Propulsion into distal
For defecation
movement, weak
Distension of duodenum
system
colon or rectum
peristalsis
Colon irritation (if any)
Intense mass movement
Peristaltic wave in
Force feces toward the
descending colon
anus > initial reflexive
Rectal mechanoreceptors
Feces in rectum >
Intrinsic reflex in local
Myenteric plexus >
Sigmoid
contraction of external
> signal spread through
distension of rectum
enteric nervous system
smooth muscle
Rectum
anal sphincter
myenteric plexus
Internal anal sphincter
Prepare for defecation
Defecation
relax
Reflexive partial
Further distension of
Urge of defecation, can
Sacral spinal cord reflex
relaxation of external anal
rectum
be voluntarily overidden
sphincter
Urge of defecation +
External anal sphincter
Voluntarily control the
Motor cortex
Pudenal nerve
voluntary command
contract/ relax
time of defecation

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